Healthcare Provider Details

I. General information

NPI: 1568074482
Provider Name (Legal Business Name): JULIA PATRICIA SANDERS LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2020
Last Update Date: 05/17/2023
Certification Date: 05/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HARBORVIEW DR UNIT 408
BALTIMORE MD
21230-5436
US

IV. Provider business mailing address

100 HARBORVIEW DR UNIT 408
BALTIMORE MD
21230-5436
US

V. Phone/Fax

Practice location:
  • Phone: 443-827-3528
  • Fax:
Mailing address:
  • Phone: 443-827-3528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number3037
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC13063
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: